Common psychiatric disorders(CPDs)and depression contribute significantly to the global epidemic of type 2 diabetes(T2D).We postulated a possible pathophysiological mechanism that through Bridge-Symptoms present in de...Common psychiatric disorders(CPDs)and depression contribute significantly to the global epidemic of type 2 diabetes(T2D).We postulated a possible pathophysiological mechanism that through Bridge-Symptoms present in depression and CPDs,promotes the establishment of emotional eating,activation of the reward system,onset of overweight and obesity and,ultimately the increased risk of developing T2D.The plausibility of the proposed pathophysiological mechanism is supported by the mechanism of action of drugs such as naltrexonebupropion currently approved for the treatment of both obesity/overweight with T2D and as separate active pharmaceutical ingredients in drug addiction,but also from initial evidence that is emerging regarding glucagon-like peptide 1 receptor agonists that appear to be effective in the treatment of drug addiction.We hope that our hypothesis may be useful in interpreting the higher prevalence of CPDs and depression in patients with T2D compared with the general population and may help refine the integrated psychiatric-diabetic therapy approach to improve the treatment and or remission of T2D.展开更多
Objective: To explore the effect of psychological intervention on glucose metabolism in patients with type 2 diabetes mellitus (T2DM) accompanying depression in community. Methods: Four hundred and ten cases of T2DM p...Objective: To explore the effect of psychological intervention on glucose metabolism in patients with type 2 diabetes mellitus (T2DM) accompanying depression in community. Methods: Four hundred and ten cases of T2DM patients in the Community Health Service Center of Friendship Office (Bao-tou) were chosen as the research objects. The evaluation and analysis were made according to Zung self-rating depression scale (SDS), and 176 cases of T2DM patients with depression were found out in the community. 176 cases of T2DM patients with depression were divided into the experimental group and the control group by use of random number table, with 88 cases in each group. The control group was treated with conventional therapy, while the experimental group was given psychological intervention treatment on the basis of conventional therapy. After 3-month psychological intervention, fasting blood glucose (FPG), two-hour postprandial blood glucose (PG2h), glycosylated hemoglobin (HbA1c) and Zung self-rating Depression Scale (SDS) were measured in two groups. In two months after psychological intervention stopped, the follow-up was conducted to determine the levels of FPG, PG2h and HbA1c, and to assess the level of depression and quality of life. Statistical analysis was performed by use of SPSS 17.0 statistical software. Results: After 3-month psychological intervention, the levels of FPG, PG2h and HbA1c in the experimental group were sig-nificantly lower than those in the control group, the depression index was significantly lower than that in the control group as well, the difference was statistically significant (p < .01). In two months after psychological intervention stopped, glucose metabolism indicators in the experimental group were significantly lower than those in the control group;the depression index was dramatically lower than that in the control group, the difference was of statistical significance (p < .01). Conclusions: Psychological intervention can effectively improve the depression symptoms and glucose metabolism indicators in T2DM patients with depression in community, but it needs a long-term persistence.展开更多
AIM To systematically review the literature on women with both diabetes in pregnancy(DIP) and depression during or after pregnancy. METHODS In this systematic literature review, PubM ed/MEDLINE and EMBASE were searche...AIM To systematically review the literature on women with both diabetes in pregnancy(DIP) and depression during or after pregnancy. METHODS In this systematic literature review, PubM ed/MEDLINE and EMBASE were searched(13 November 2015) using terms for diabetes(type 1, type 2, or gestational), depression, and pregnancy(no language or date restrictions). Publications that reported on women who had both DIP(any type) and depression or depressive symptoms before, during, or within one year after pregnancy were considered for inclusion. All study types were eligible for inclusion; conference abstracts, narrative reviews, nonclinical letters, editorials, and commentaries were excluded, unless they provided treatment guidance.RESULTS Of 1189 articles identified, 48 articles describing women with both DIP and depression were included(sample sizes 36 to > 32 million). Overall study quality was poor; most studies were observational, and only 12 studies(mostly retrospective database studies) required clinical depression diagnosis. The prevalence of concurrent DIP(any type) and depression in general populations of pregnant women ranged from 0% to 1.6%(median 0.61%; 12 studies). The prevalence of depression among women with gestational diabetes ranged from 4.1% to 80%(median 14.7%; 16 studies). Many studies examined whether DIP was a risk factor for depression or depression was a risk factor for DIP. However, there was no clear consensus for either relationship. Importantly, we found limited guidance on the management of women with both DIP and depression. CONCLUSION Given the increasing prevalence of diabetes and depression, high-quality research and specific guidance for management of pregnant women with both conditions are warranted.展开更多
The aim of this paper is to describe the direction of the link between stress,depression,increased inflammation and brain-derived neurotrophic factor(BDNF)reduction.We hypothesize that severe stress or prolonged stres...The aim of this paper is to describe the direction of the link between stress,depression,increased inflammation and brain-derived neurotrophic factor(BDNF)reduction.We hypothesize that severe stress or prolonged stress can be the driving factor that promote the onset of depression.Both stress and depression,if not resolved over time,activate the production of transcription factors that will switch on pro-inflammatory genes and translate them into cytokines.This cascade fosters systemic chronic inflammation and reduced plasma BDNF levels.Since people with depression have a 60%increased risk of developing type 2diabetes(T2D)and show high levels of inflammation and low levels of BDNF,we hypothesize possible reasons that might explain why T2D,depression and dementia are often associated in the same patient.展开更多
Patients with diabetes mellitus(DM) need psychological support throughout their life span from the time of diagnosis. The psychological make-up of the patients with DM play a central role in self-management behaviors....Patients with diabetes mellitus(DM) need psychological support throughout their life span from the time of diagnosis. The psychological make-up of the patients with DM play a central role in self-management behaviors. Without patient's adherence to the effective therapies, there would be persistent sub-optimal contro of diseases, increase diabetes-related complications,causing deterioration in quality of life, resulting in increased healthcare utilization and burden on healthcare systems. However, provision of psychosocial support is generally inadequate due to its challenging nature of needs and demands on the healthcare systems. This review article examines patient's psychological aspects in general, elaborates in particular about emotion effects on health, and emotion in relation to other psychological domains such as cognition, self-regulation,self-efficacy and behavior. Some descriptions are also provided on willpower, resilience, illness perception and proactive coping in relating execution of new behaviors,coping with future-oriented thinking and influences of illness perception on health-related behaviors. These psychological aspects are further discussed in relationto DM and interventions for patients with DM. Equipped with the understanding of the pertinent nature of psychology in patients with DM; and knowing the links between the psychological disorders, inflammation and cardiovascular outcomes would hopefully encourages healthcare professionals in giving due attention to the psychological needs of patients with DM.展开更多
It has long been accepted that psychological factors adversely influence efforts to optimise glycaemic control.These are often unrecognised in terms of clinical assessment and therefore under reported.This essay prese...It has long been accepted that psychological factors adversely influence efforts to optimise glycaemic control.These are often unrecognised in terms of clinical assessment and therefore under reported.This essay presents an introduction to psychological issues that interact with psychiatric co-morbidities and diabetesspecific distress,and a case scenario illustrating the interconnectedness of presenting problems and themes.In the way that we cannot separate carbohydrate counting,blood glucose monitoring and insulin doseadjustment in the understanding of a presenting problem such as poor control,so we cannot separate the concurrent thoughts,feelings,and behaviours.Each of these emotional aspects are self-managed either through avoidance,or by delayed disclosure and are frequently associated with poor health outcomes.There is a requirement for the healthcare team to be sensitised to these issues and to develop styles of communication that are empathic,reflective and non judgemental.A brief outline of evidence-based psychotherapy treatments is given.展开更多
文摘Common psychiatric disorders(CPDs)and depression contribute significantly to the global epidemic of type 2 diabetes(T2D).We postulated a possible pathophysiological mechanism that through Bridge-Symptoms present in depression and CPDs,promotes the establishment of emotional eating,activation of the reward system,onset of overweight and obesity and,ultimately the increased risk of developing T2D.The plausibility of the proposed pathophysiological mechanism is supported by the mechanism of action of drugs such as naltrexonebupropion currently approved for the treatment of both obesity/overweight with T2D and as separate active pharmaceutical ingredients in drug addiction,but also from initial evidence that is emerging regarding glucagon-like peptide 1 receptor agonists that appear to be effective in the treatment of drug addiction.We hope that our hypothesis may be useful in interpreting the higher prevalence of CPDs and depression in patients with T2D compared with the general population and may help refine the integrated psychiatric-diabetic therapy approach to improve the treatment and or remission of T2D.
文摘Objective: To explore the effect of psychological intervention on glucose metabolism in patients with type 2 diabetes mellitus (T2DM) accompanying depression in community. Methods: Four hundred and ten cases of T2DM patients in the Community Health Service Center of Friendship Office (Bao-tou) were chosen as the research objects. The evaluation and analysis were made according to Zung self-rating depression scale (SDS), and 176 cases of T2DM patients with depression were found out in the community. 176 cases of T2DM patients with depression were divided into the experimental group and the control group by use of random number table, with 88 cases in each group. The control group was treated with conventional therapy, while the experimental group was given psychological intervention treatment on the basis of conventional therapy. After 3-month psychological intervention, fasting blood glucose (FPG), two-hour postprandial blood glucose (PG2h), glycosylated hemoglobin (HbA1c) and Zung self-rating Depression Scale (SDS) were measured in two groups. In two months after psychological intervention stopped, the follow-up was conducted to determine the levels of FPG, PG2h and HbA1c, and to assess the level of depression and quality of life. Statistical analysis was performed by use of SPSS 17.0 statistical software. Results: After 3-month psychological intervention, the levels of FPG, PG2h and HbA1c in the experimental group were sig-nificantly lower than those in the control group, the depression index was significantly lower than that in the control group as well, the difference was statistically significant (p < .01). In two months after psychological intervention stopped, glucose metabolism indicators in the experimental group were significantly lower than those in the control group;the depression index was dramatically lower than that in the control group, the difference was of statistical significance (p < .01). Conclusions: Psychological intervention can effectively improve the depression symptoms and glucose metabolism indicators in T2DM patients with depression in community, but it needs a long-term persistence.
文摘AIM To systematically review the literature on women with both diabetes in pregnancy(DIP) and depression during or after pregnancy. METHODS In this systematic literature review, PubM ed/MEDLINE and EMBASE were searched(13 November 2015) using terms for diabetes(type 1, type 2, or gestational), depression, and pregnancy(no language or date restrictions). Publications that reported on women who had both DIP(any type) and depression or depressive symptoms before, during, or within one year after pregnancy were considered for inclusion. All study types were eligible for inclusion; conference abstracts, narrative reviews, nonclinical letters, editorials, and commentaries were excluded, unless they provided treatment guidance.RESULTS Of 1189 articles identified, 48 articles describing women with both DIP and depression were included(sample sizes 36 to > 32 million). Overall study quality was poor; most studies were observational, and only 12 studies(mostly retrospective database studies) required clinical depression diagnosis. The prevalence of concurrent DIP(any type) and depression in general populations of pregnant women ranged from 0% to 1.6%(median 0.61%; 12 studies). The prevalence of depression among women with gestational diabetes ranged from 4.1% to 80%(median 14.7%; 16 studies). Many studies examined whether DIP was a risk factor for depression or depression was a risk factor for DIP. However, there was no clear consensus for either relationship. Importantly, we found limited guidance on the management of women with both DIP and depression. CONCLUSION Given the increasing prevalence of diabetes and depression, high-quality research and specific guidance for management of pregnant women with both conditions are warranted.
文摘The aim of this paper is to describe the direction of the link between stress,depression,increased inflammation and brain-derived neurotrophic factor(BDNF)reduction.We hypothesize that severe stress or prolonged stress can be the driving factor that promote the onset of depression.Both stress and depression,if not resolved over time,activate the production of transcription factors that will switch on pro-inflammatory genes and translate them into cytokines.This cascade fosters systemic chronic inflammation and reduced plasma BDNF levels.Since people with depression have a 60%increased risk of developing type 2diabetes(T2D)and show high levels of inflammation and low levels of BDNF,we hypothesize possible reasons that might explain why T2D,depression and dementia are often associated in the same patient.
文摘Patients with diabetes mellitus(DM) need psychological support throughout their life span from the time of diagnosis. The psychological make-up of the patients with DM play a central role in self-management behaviors. Without patient's adherence to the effective therapies, there would be persistent sub-optimal contro of diseases, increase diabetes-related complications,causing deterioration in quality of life, resulting in increased healthcare utilization and burden on healthcare systems. However, provision of psychosocial support is generally inadequate due to its challenging nature of needs and demands on the healthcare systems. This review article examines patient's psychological aspects in general, elaborates in particular about emotion effects on health, and emotion in relation to other psychological domains such as cognition, self-regulation,self-efficacy and behavior. Some descriptions are also provided on willpower, resilience, illness perception and proactive coping in relating execution of new behaviors,coping with future-oriented thinking and influences of illness perception on health-related behaviors. These psychological aspects are further discussed in relationto DM and interventions for patients with DM. Equipped with the understanding of the pertinent nature of psychology in patients with DM; and knowing the links between the psychological disorders, inflammation and cardiovascular outcomes would hopefully encourages healthcare professionals in giving due attention to the psychological needs of patients with DM.
文摘It has long been accepted that psychological factors adversely influence efforts to optimise glycaemic control.These are often unrecognised in terms of clinical assessment and therefore under reported.This essay presents an introduction to psychological issues that interact with psychiatric co-morbidities and diabetesspecific distress,and a case scenario illustrating the interconnectedness of presenting problems and themes.In the way that we cannot separate carbohydrate counting,blood glucose monitoring and insulin doseadjustment in the understanding of a presenting problem such as poor control,so we cannot separate the concurrent thoughts,feelings,and behaviours.Each of these emotional aspects are self-managed either through avoidance,or by delayed disclosure and are frequently associated with poor health outcomes.There is a requirement for the healthcare team to be sensitised to these issues and to develop styles of communication that are empathic,reflective and non judgemental.A brief outline of evidence-based psychotherapy treatments is given.
